Journal article
Accuracy of volumetric bone mineral density measurement in weight bearing, cone beam computed tomography
Journal of clinical densitometry, Vol.27(3), 101504
06/06/2024
DOI: 10.1016/j.jocd.2024.101504
Abstract
Background: Weight bearing computed tomography (WBCT) utilizes cone beam CT technology to provide assessments of lower limb joint structures while they are functionally loaded. Grey-scale values indicative of X-ray attenuation that are output from cone beam CT are challenging to calibrate, and their use for bone mineral density (BMD) measurement remains debatable. To determine whether WBCT can be reliably used for cortical and trabecular BMD assessment, we sought to establish the accuracy of BMD measurements at the knee using modern WBCT by comparing them to measurements from conventional CT.
Methods: A hydroxyapatite phantom with three inserts of varying densities was used to systematically quantify signal uniformity and BMD accuracy across the acquisition volume. We evaluated BMD in vivo (n = 5, female) using synchronous and asynchronous calibration techniques in WBCT and CT. To account for variation in attenuation along the height (z-axis) of acquisition volumes, we tested a height-dependent calibration approach for both WBCT and CT images.
Results: Phantom BMD measurement error in WBCT was as high as 15.3% and consistently larger than CT (up to 5.6%). Phantom BMD measures made under synchronous conditions in WBCT improved measurement accuracy by up to 3% but introduced more variability in measured BMD. We found strong correlations (R = 0.96) as well as wide limits of agreement (-324 mgHA/cm3 to 183 mgHA/cm3) from Bland-Altman analysis between WBCT and CT measures in vivo that were not improved by height-dependent calibration.
Conclusion: Whilst BMD accuracy from WBCT was found to be dependent on apparent density, accuracy was independent of the calibration technique (synchronous or asynchronous) and the location of the measurement site within the field of view. Overall, we found strong correlations between BMD measures from WBCT and CT and in vivo measures to be more accurate in trabecular bone regions. Importantly, WBCT can be used to distinguish between anatomically relevant differences in BMD, however future work is necessary to determine the repeatability and sensitivity of BMD measures in WBCT.
Details
- Title: Subtitle
- Accuracy of volumetric bone mineral density measurement in weight bearing, cone beam computed tomography
- Creators
- Tadiwa H. Waungana - Alberta Bone and Joint Health InstituteKeven Qiu - Alberta Bone and Joint Health InstituteJustin J. Tse - University of CalgaryDonald D. Anderson - Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa, United StatesCarolyn A. Emery - Alberta Bone and Joint Health InstituteSteven K. Boyd - Alberta Bone and Joint Health InstituteSarah L. Manske - Alberta Bone and Joint Health Institute
- Resource Type
- Journal article
- Publication Details
- Journal of clinical densitometry, Vol.27(3), 101504
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jocd.2024.101504
- ISSN
- 1094-6950
- eISSN
- 1559-0747
- Grant note
- Arthritis Foundation: 851789 Natural Sciences and Engineering Research Council of Canada: DG 2018-03908 Arthritis Society Stars Early Career Development Award: STAR18-0189
The contribution of author DDA was supported by a grant from the Arthritis Foundation (Award #851789) and by a Killam Visiting Scholar Award. Funding for the Alberta Youth Prevention of Early OA study cohort was provided by the Canadian Institutes of Health Research CAE. The study was supported by the Natural Sciences and Engineering Research Council of Canada (DG 2018-03908) , the American Society for Bone and Mineral Research Rising Star Award and the Arthritis Society Stars Early Career Development Award (STAR18-0189) SLM.
- Language
- English
- Date published
- 06/06/2024
- Academic Unit
- Orthopedics and Rehabilitation; Roy J. Carver Department of Biomedical Engineering; Industrial and Systems Engineering
- Record Identifier
- 9984643753902771
Metrics
2 Record Views